Hmmm…. Interesting that my week where my blog posts are late is the week to talk about motivation…

The last couple of weeks have been pretty tough. My neck started bothering me a lot, so it was hard to use the computer much, but I’ll admit, I’ve also been having a bit of a lack of motivation lately! Not just for this course, but for everything!

After watching “The Puzzle of Motivation” TED talk with Dan Pink, I kind of wonder if I might realize why I started to feel this way…

Firstly, I guess let’s go to overall motivation. I generally have not ever been someone who liked writing. I love to read (there are 9 bookshelves in my room), but writing… it’s never something that held a lot of appeal for me, so the lack of intrinsic motivators that Dan Pink talks about seems to be quite lacking for me with writing. On the other hand, I am quite motivated to learn about education and see if my own ideas about it are consistent with those that are commonly regarded, so perhaps there exists a bit of intrinsic motivation there?

That brings me to my second point, which is about what Dan Pink described as the Carrot vs the Stick. The central tenet of his ideas seems to be the “True Fact” that incentives or punishments are not effective in getting people to complete tasks, unless they are relatively simple ones that do not involve much creativity. The funny thing for me was that as I was listening to the talk, what came into my head was the idea that this apparently ineffective concept is actually being partly applied in this course, in the sense that there is no marking punishment for late assignments, but that the apparent punishment is that no feedback is given either.

I guess that on reflection, the fact that incentives do not really serve to motivate is not that big of a surprise to me. As Dan Pink said, we know this in our hearts, that the science is actually true. I always used to be more successful in studying things that were of interest to me, even if they were considered harder, than things that were of little interest to me. I’m kind of lucky, in a sense, in that I feel like I am someone who likes to learn, but the methodology also has an impact on this, naturally. This will probably lead into future blog posts. My takeaway from this is that if I have the opportunity to teach, I’m going to try to impart some enthusiasm for the subject into people somehow, and not focus on punishments or incentives, but incentives for simple things, such as just coming to class for attendance, may still be effective.

Memory. It is an essential part of being able to live life well, and it is probably either the first or second-most important of the declining body processes as we get older. Alzheimer’s disease, vascular dementia, Lewy body disease, cerebrovascular disease…. these all have the potential to interfere with our memory, not to mention stress, depression, mental health disorders, concussions, brain injury….

So, we have a lot of ways to lose memory, but how do we gain memories? Memories, according to the Crash Course Psychology YouTube broadcast, from a summation of earlier research, involves encoding, short-term memory, and long-term memory. Short-term memory is only meant to involve about 30 seconds of recall, and often involves shallow processing, whereas deeper processing is required for long-term storage. The difference between the two are dependent on whether a deeper meaning connection is made between the information or not, whereas the shallow processing is merely about basic sense input, such as sight, sound, etc.

Recall from long-term memory often involves cues to be presented, which then trigger the recall of the full memory. An example in the video of this is that returning to the room where the thought originated will often cause someone to remember what they intended prior to getting distracted.

These videos do not directly discuss why memory tends to worsen with age, but from a medical perspective, it all has to do with brain cells (neurons) getting damaged. However, there has been some limited research that shows that repetitive use of the brain can help to prevent dementia, in the form of mental exercises, such as crossword puzzles.

Medical education and training is done in many ways. In my case, it included all of the following: large lecture rooms, small group labs, smaller group active demonstrations and tactile learning, mannequin simulations, actor simulations, participation in real-world situations as an observer, active participation in real-world situations as a team member, and even real-world situations where I needed to figure out and execute what to do on my own.

Having had this variety of experience, I feel that for me, at least, experiential learning was the best way to understand and more importantly, remember the material being taught. As mentioned in my previous blog post, the methodology of teaching is quite important to tailor to the person being taught, but failing this one-on-one teaching potential, I believe that experiential learning would be the most ideal way to encourage learning. One limited method of this is known as Problem-Based Learning or PBL, which I had some limited experience with in University. PBL works by having small groups with a facilitator. The facilitator aids the group in choosing a topic, and then the group self-organizes to break the topic up into sub-topics. In pathology, this can include such things as the mechanism of action, the symptoms, the signs, the life-cycle of the pathogen/pathological condition, the side effects, the complications, and so-on. Each member of the small group then takes on an element to study, and the group meets up later, with the facilitator, to present their information, and essentially teach the rest of the group what they have found. This is not a truly experiential technique, but the investment for the student is higher, similar to an experiential situation, because other people are also relying on their successful research findings. This is obviously a huge motivator in medical/health situations, as someone’s well-being would completely depend on your findings and subsequent actions based on those findings. This also tends to result, for me, in a higher level of memory for the situation, findings and action to be taken if the situation were to arise again.

The trouble with experiential learning is that it is often quite time and resource-consuming. Mentorship was largely abandoned in modern society due to the sheer numbers of people who needed to be taught a given skill or area, and mass-teaching became the norm instead. Mentorship during a real-world situation would certainly be an excellent form of experiential learning, and continues to be so, for some very select professions.

Interestingly, my blog partner Sherri and I actually talked about learning forms a few weeks ago, and we actually came to the conclusion that video learning, such as with video tutorials, would probably be the best form of learning, and I realize now that we were probably thinking of the best form of mass-learning. Experiential learning, from my own experience, and based upon some of the reasearch, it would also seem that it results in deeper learning as well, with better memory recall. If there were better ways to mitigate large class sizes, this would be an excellent way to teach.

According to Sheridan (2012) ,”One of my favorite techniques is to stop the lecture, put on a mysterious expression, and look directly at the disruptive student. I announce to the class that I am getting a vision of that student sitting in the same chair next semester repeating the class over again. Usually the whole class laughs, but it gets the message across to everyone that this particular behavior has consequences.”

This quote is cited in the article “Classroom Management Tips for Regaining Control in the Classroom” as an example of how humour can be effective.

Objective

Objectively, this quote deals with the aspects of both reducing the disruption and delivering a learning message to the entire class about an aspect of student behaviour and a method of regaining control of the classroom when it is threatened.

Reflective

Reflectively, my initial response to this quote is quite strongly that this is a very bad idea. Not only does this cause humiliation to a student in front of the whole class and therefore encourage the student to become more disruptive, but it also risks the class to unite behind the student against the mean, malicious teacher. Additionally, I feel like it would not in any way dissuade the student in question from avoiding similar behaviour in the future, as they may feel that there is nothing or very little they can do to regain the teacher’s good favour and therefore, why bother. This could also be something done in the classroom that would encourage further bullying in a classroom, as the teacher is meant in many ways to lead by example, and this would not be a good example to follow, of public humiliation.

Interpretational

In my interpretation, this quote could easily be construed as bullying and this is something I have had some experience with, therefore I would not encourage this kind of behaviour in a teacher, and I would probably end up counselling a fellow instructor to be very cautious in using this kind of method. I suppose that the quote is trying to say that humour can be a useful tool in regaining the class’ attention, but doing it in this way does not seem to me to be an attitude that will encourage better behaviour, despite the idea that consequences will ensue. I would interpret this quote as the idea that humour could be used, but I think I would try to find another way, perhaps a way to invite the students to share the joke, rather than making them a target of it. Perhaps this was not intended from the way the qu0te was written and in practice, things would actually be different, but publicly targeting someone in order to illustrate and consequence is not, in my opinion, a productive methodology.

Decisional

This exercise has made me realize that the interpretation of methods can be very variable. When I first thought of the idea of using humour for a classroom technique, I thought this could be very powerful, but also a bit risky for the teacher, as badly taken humour is often even harder to overcome from a perspective of respect towards a teacher, and could in fact result in a further deterioration of classroom control. However, this particular teacher’s method, to me, is more an illustration of public shaming to illustrate a mistake and the consequences of such. I still do not feel that this is appropriate, but even more importantly, I think that this should illustrate that the discussion of ideas like this needs to be thorough, to avoid misconception, which can further deteriorate during the process of ideas application.

Had a nice Skype call with Sherri. It’s been a busy, busy, momentous week! But I digress… Items we discussed are:

What are some trends in your field?

Sherri has been quite observant about her field and some of the new trends involved in it, which tend to include the idea of constant interaction with the client as well as the idea that the family is almost always involved in events together these days in Adventure Travel. Gone are the days when it was more routine to see a family split up, they tend to want to do activities together now. Sometimes, this can mean that parents will become a bit lax in their parenting duties, but this is usually fairly easy to rectify with a brief reminder that these duties never tend to get a break!

What are some trends in adult education?

We both talked about how while video may be the ideal teaching method for distance education, personal interaction with a small group is most likely the ideal method for education in general, if possible. As an example, I discussed a PBL group in one of my undergraduate classes at UBC, where each member had a responsibility to learn a section of the problem, then return to teach it to the rest of the group. We also were in agreement that the ability/opportunity to teach something to others was one of the best benchmarks for whether the topic has actually been adequately learned.

How will your roles and responsibilities change as you take on more teaching or

training responsibilities in the future?

Both of us see teaching/training in our fields as potential replacement or supplemental areas in our lives, which may necessitate us to give up some or all of our current work to pursue the new work in education, but we will both have to assess that aspect of things if and when the teaching opportunities present.

This article discussed some expected key trends for adult learning in 2016.

The concept of the Ebbinghaus forgetting curve was a new one to me, but it does make a great deal of sense, especially the “boost” concept that is discussed. I imagine it does need to be supported with research, but the idea that repetition or reinforcement of concepts makes sense to me on a common sense level as well.

The concept of the LinkedIn Economic Graph Challenge is also an interesting, but difficult, one. I have encountered this before, in medicine, as the matching process for medical residency involves a short-list of candidates submitted by the program, as well as a short-list of residency sites submitted by the candidate, and then an algorithm is used to get the two lists to interact. This would be much more difficult in the business world compared to a known quantity of programs available for medical residency, as there could be hundreds or even thousands of businesses of which the candidates may not be aware. New trends such as crowdsourcing, which is discussed, will only reach certain segments of the population, no matter how well populated a given crowdsourcing website may be.

I think that personally, I do not really consider cloud-based learning or video approaches to learning to be new trends or concepts, but I would be quite supportive of these becoming more prevalent, and I hope that this mention of them as trends, means this is becoming so.

The concept of instructor quality is a big reason I am in this program. I feel that in order to give any potential future students my best effort, I need to be providing quality education, and I hope this course will lead to that.

Accelerated curricula are a wonderful concept in theory, but in practice, they would only succeed if there were enough resources present for them, which tends to be an issue quite often, based on some other reading I have done in the past. I would be very interested in finding out a bit more about the relative success of these programs in preparing students and the satisfaction level of the graduates and students as well.

First of all, according to some publications, the definition of the term “adult” itself, comes initially into question. There does not seem to be any set age range, although older than 24 seems to be the lower limit of the threshold. This obviously makes further conclusions very hard to draw.

However, this article in particular draws attention to the following generalized characteristics when it comes to an adult learner: Autonomy, Goal-Oriented, Practical, Competence and Mastery, Learning by experience, Wealth and Knowledge, Purposeful, Emotional barriers, Results-oriented, Outside responsibilities, Potential physical limitations, Big Picture, Responsible for self, and Need for Community.

I would venture that to my mind, the most important of these characteristics are: Emotional Barriers, Potential Physical Limitations, and Results- oriented. Emotional and physical barriers are non-conducive to any form of learning at all, as the distractions that come from emotional barriers will preclude good learning, and physical limitations can often lead to emotional upset, or a feeling that the learner is no longer as capable or competent as they once were. Results- oriented is described in this article as a successful acheievement of specific expectations when it comes to learning. This is very important for the adult learner as they are often juggling their Outside Responsibilities, and if they feel that something is not worthwhile, they will choose not to pursue it as the best use of their limited time.

I was born in the United Kingdom after my parents both emigrated there from India. My father is a Civil Engineer, and my mother has a degree in Economics, but worked as a librarian and as an ESL teacher during her life. We moved to Canada and to Richmond when I was 2 years old. I was enrolled in the early French Immersion Programme in Elementary school from kindergarten and completed this up till Grade 12, along with some International Baccalaureate Certificates in Secondary School. I then went to UBC, earning a degree in Integrated Sciences, as one of the first graduates of that program. In my fourth year at UBC, I was exposed to some pathology courses, and greatly enjoyed learning about the anatomy, physiology and capabilities of the human body and the parasites which tried to subvert our native defenses. I spent the next two years in taking the MCAT and applying for medical school, and to my surprise, the first place that accepted me as into the medical program was in Dublin, Ireland, at the Royal College of Surgeons in Ireland. So I went off to Ireland for medical school. After 5 years there, I stayed there for an extra year to work in a hospital, and then I returned to Canada with the idea to get into a residency for Family Medicine. I matched the year after into a new residency up in Northern BC, in Dawson Creek. I was there for 2 years training, then locum for a few months, before moving back down to Vancouver. I have worked as a Family Physician in Burnaby for the last 4 years. I have become interested in teaching, partly through my experiences in teaching medical students and residents, and partly in my experiences teaching people board games and ballroom dancing, which have been hobbies of mine since my early years at UBC, and I now hope to get into academic teaching in some form, sometime in the future.

2) My learning partner’s blog: trialofskyle.wordpress.com

3) Trends in Medicine

One of the biggest trends in medicine that I have observed over the past few years in practice is that of personal technology in medicine. Whether this be as simple as the tendency to Google symptoms before coming into the office, or as complex as the modern use of tablets in hospitals, there are many areas where technology has entered the medical field, and continues to have an impact.

One of the earliest evidences of technology in personal/patient/consumer health care in BC was likely the initiation of the My E-health program from Lifelabs. Patients could now look at their own blood results at home, along with a partial breakdown of the normal range levels for the various blood results.

This brings up one of the quotes in this particular article: “Patients are coming to our offices armed already with information or a diagnosis of what they think they have,” he says. “It is up to us as physicians to accept this new paradigm and become partners with patients.”

I somewhat agree with this statement that the new paradigm is to deal with patients armed with information already, and I am fully supportive of the idea that patients should have good access to information. However, I do not agree with the idea that this new partnership is an equal one. There are 2 points in particular where I will try to illustrate this. Both “partners” in this endeavour have equal access to information, but this is where the partnership becomes unequal. The inequality on the part of the patient lies with the thinking that 1) only the patient can describe adequately how the symptoms of a particular illness may be affecting them. This includes the idea of the severity, the frequency and the impact on them psychosocially as well. The inequality on the part of the physician exists due to the fact that although both members of this partnership can access the same information, 2) the physician has superior experience in interpreting the information and coming to a more definite conclusion. Naturally, any human being can always be wrong, but in terms of the odds, the physician is at much lower odds of bring wrong, an therefore the physician’s responsibility should be to listen to the patient as much as possible when they are describing the issues (symptoms, impact, etc), while the patient’s responsibility should be to assume that the physician will have a superior opinion as to the cause of the issues. That being said, a good physician will continually adjust to new information that the patient is bringing in, and should be reacting to any new information (such as treatment failures), accordingly.

Another quote that gives an example my points from the above discussion is here, from the same article:”Although “Dr. Google” is always on-call for the American public, the online medical advice being doled out is not always accurate. The same can be said of the more than 13,000 health and medical apps now available for mobile devices. A recent report in JAMA Dermatology, for example, found that that three out of four melanoma-diagnosing apps reviewed misclassified at least 30% of melanoma lesions.”

One trend which I am quite looking forward to in health care is that of the mobile app/watch/wristband/etc. I believe that these devices have a great potential to be able to inform us of issues arising from our general health, but I do hope that the role of the family physician will always be considered an important one in society.

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